The Delta Health Alliance (DHA) proposes to demonstrate the effects of diabetes management practices at several ambulatory clinics throughout Mississippi when utilizing well-designed, comprehensive health information technology. The timing of the proposed study coincides with independent plans to implement electronic health records at these sites;hence, an invaluable opportunity exists to compare similar practices of healthcare providers and health outcomes of their patients with and without utilization of a comprehensive health information technology system. The prevalence and incidence of diabetes in the U.S. are reaching epidemic proportions, and this is especially true in Mississippi. Over the past five years, the DHA has been sponsoring the Delta Diabetes Project (DDP), a regional network of clinical sites that employs a multidisciplinary chronic care model that adheres to the American Diabetes Association's standards of medical care for patients with diabetes. DDP providers are caring for approximately 5,000 patients, the majority of whom are African American, impoverished, and typically suffer from inadequate access to medical care. The proposed BLUES Project (BLUES is an acronym for Bettering Lives Utilizing Electronic Systems), is designed to determine whether utilization of health IT in diabetes management will enhance delivery of healthcare and improve health outcomes among patients. Four diabetes management clinics that employ the same model of diabetes care will participate in this study: two are located in an urban setting (one of which will utilize the health IT system), and two in a rural setting (one of which will utilize the health IT system). The proposed study includes three specific aims: (1) successfully implement an electronic health record (EHR) system in two existing diabetes management clinics, focusing on integration of the EHR into clinician workflows;(2) evaluate the impact of the EHR system on clinical processes of care and patient outcomes;and (3) based on the lessons learned and evaluation results, produce and distribute a generalizable, replicable model of care for implementing an integrated health IT system for diabetes management care throughout the U.S.